Yang Jeong-In, Kim Haeng-Soo, Chang Ki-Hong, Hong Jeong, Joo Hee-Jae, Ryu Hee-Sug
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea.
Am J Perinatol. 2004 May;21(4):241-6. doi: 10.1055/s-2004-828607.
Intrauterine intussusception, an uncommon cause of bowel obstruction, has rarely been detected by prenatal ultrasonography. We report two cases of intrauterine intussusception after gestation, which presented as isolated fetal ascites at 30 weeks of gestation by ultrasonography. In case 1, on the follow-up ultrasonography at 32 weeks of gestation, the previously observed ascites had disappeared, whereas the echogenicity of the bowel was increased without any sign of dilation, suggesting the presence of meconium peritonitis. The fetus was delivered at 39 weeks. In case 2, however, the amount of fetal ascites became increased, and the fetus was delivered at 34 weeks of gestation. After delivery, both infants were surgically explored with resection of the ileum with end-to-end anastomosis because of intrauterine intussusception and ileal atresia. From the experience of these cases, we suggest that the ultrasonographic finding of isolated or transient fetal ascites might contribute to the early diagnosis and management of intrauterine intussusception.
子宫内肠套叠是肠梗阻的一种罕见原因,产前超声检查很少能检测到。我们报告两例妊娠后子宫内肠套叠病例,超声检查显示在妊娠30周时表现为单纯性胎儿腹水。病例1中,在妊娠32周的随访超声检查中,之前观察到的腹水消失了,而肠管的回声增强,没有任何扩张迹象,提示存在胎粪性腹膜炎。胎儿于39周时分娩。然而,病例2中胎儿腹水增多,胎儿于妊娠34周时分娩。分娩后,由于子宫内肠套叠和回肠闭锁,两名婴儿均接受了手术探查,行回肠切除端端吻合术。根据这些病例的经验,我们认为单纯性或短暂性胎儿腹水的超声检查结果可能有助于子宫内肠套叠的早期诊断和处理。